'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

More than half of all GPs feel the NHS is ill-prepared for the second wave of the swine flu pandemic, a Pulse survey shows.

56% of the 280 GPs in the Pulse survey said they felt the NHS in their area ‘is not adequately prepared for a second wave of the swine flu pandemic.'

The same proportion - also 56% – said they felt the only way to cope with the additional workload would be to suspend elements of routine work and dedicate their practice resources to the national vaccination campaign in at-risk patient groups.

GPC chair Dr Laurence Buckman insisted negotiators had been working hard to make sure PCTs were ready and that practices were resourced to cope.

‘The intention was always to ensure that GPs had the time to deliver this, rather than just the money. Negotiations have centred around freeing up time. The money, was obviously important, but not the central issue.'

‘We now have to get it legally watertight and make sure it is possible for everyone to do it. PCOs will be starting to get going with LMCs on matters that need to be discussed and organised. All of that can happen prior to the vaccine being licensed. We're well on target for that.'

The majority of GPs have already begun to organise themselves for the second wave of the swine flu pandemic, and 68% say they have buddying-up arrangements in place with local practices.

At present there is no national agreement to reimburse practices that have to drop enhanced services or QOF work - except in extreme circumstances under buddying-up arrangements - but the GPC and Government are continuing to discuss the issue.

There will be hope, too, that the Department of Health will look again at its policy for issuing Tamiflu, with prescribing experts this month calling for an urgent review.

As first revealed on pulsetoday.co.uk, 91% of the GPs surveyed said they believed the Government should review its policy of offering Tamiflu to all patients with swine flu symptoms, and more than a third – 37% - said their patients had suffered complications after being given Tamiflu following a misdiagnosis of swine flu.

Dr Ellen Wright, a GP in Greenwich, south London, said: ‘I think it's time to review the policy. From the outset there was a lot of pressure on the Government, and that's probably why they adopted a blanket approach. But I think I speak for the majority of GPs in saying it's high time to look again at the policy.'